Is Dementia the Third Type of Diabetes?

Seeing your loved ones slowly lose their cognitive abilities and the traits that make them so special is absolutely heartbreaking. Dementia has a way of taking your loved one from you even when they’re still alive. 

According to the World Health Organization, WHO, dementia is the 7th leading cause of death and one of the major causes of disability among older people across the globe.

Dementia is not only more common in women, but women also provide 70% of care hours for people with dementia, meaning it affects women disproportionately whether they are patients or caregivers. 

With dementia being a reality for many older people and the loved ones who care for them, it’s important to consider what may be behind it. More and more research has linked dementia with insulin resistance and diabetes. Some experts even call it the “third type of diabetes.”

Dementia Overview

Dementia isn’t one specific condition, but rather a term for several diseases that can impact someone’s thinking and memory, as well as their ability to perform every task.

It mainly affects people who are 65 and older and tends to get worse over time. Dementia can also cause changes in mood and behavior, and those with it may eventually have difficulty moving around, going to the bathroom, and eating and drinking.

There’s a wide range of diseases and injuries that can cause someone to develop dementia, the most common being Alzheimer’s disease. Dementia can also be caused by strokes, brain injuries, HIV, vascular dementia, and nutritional deficiencies. 

Symptoms of dementia can vary widely between individuals and at different stages of the disease. Here are some common ones:

• Misplacing or losing things
• Difficulty tracking time
• Forgetting recent events
• Difficulty following conversations or finding the right words
• Social withdrawal
• Changes in personality
• Feeling sad, angry, or anxious about cognitive changes
• Feeling confused even when somewhere familiar

While genetics can play a role in some types of dementia, certain lifestyle choices and underlying disorders can also increase someone’s chances of developing it. Things like high blood pressure, smoking, high levels of alcohol consumption, social isolation, depression, and even diabetes can all increase the risk of dementia. 

Diabetes Overview

Now a quick pivot to the basics of diabetes before we explore its relationship to dementia. There are three main types of diabetes, type 1, type 2, and gestational diabetes which happens during pregnancy.

All forms of diabetes impact the body’s ability to use insulin. Insulin is a hormone that regulates blood sugar by entering the body’s cells for energy and signaling the liver to store blood sugar for later use.

Type 1 diabetes is generally considered an autoimmune disease that causes the body to stop creating insulin. This type is less common and is more likely to be diagnosed in children or young adults, although it can develop at any age. People with type 1 diabetes need insulin to live.

Type 2 diabetes is when the body doesn’t use insulin well and has difficulty regulating blood sugar levels. It is typically caused by lifestyle factors. Those with type 2 diabetes can often manage the condition with lifestyle changes but may need to take insulin medication as well. 

The Link Between Dementia and Diabetes

It’s been known that diabetes can lead to cognitive impairment, but new research suggests that diabetes can increase someone’s risk of developing dementia. One study even found that those with prediabetes also have a higher risk of dementia. 

Another longitudinal study found that not only does diabetes increase someone’s risk of developing dementia, but age also plays a role. Researchers found that diabetes onset at a younger age significantly increased someone’s chance of developing dementia later in life. 

What do these seemingly unrelated diseases have to do with each other? Researchers and medical professionals aren’t exactly sure how diabetes can increase dementia rates, but they have some ideas. 

How Diabetes May Lead to Dementia

You’ll remember that diabetes affects the body’s ability to produce or use insulin correctly. Besides playing a key role in blood sugar regulation, insulin has also been identified as a key player in cognitive processes like memory. Insulin is likely transported into the central nervous system in the brain through the blood-brain barrier. 

While most insulin is produced in the pancreas, the brain may create it as well. Low blood sugar (hypoglycemia) may impact insulin in the brain, which can potentially damage the hippocampus, the part of the brain responsible for memory.

There is a known link between diabetes and heart or cardiovascular disease. Heart disease can increase the risk of stroke, which can lead to dementia. This explanation doesn’t paint the whole picture, as people with cardiovascular disease have an increased risk of developing dementia without having had a stroke.

Another link between diabetes and dementia has to do with oxygen and nutrition in the brain. Over time, diabetes can narrow the capillaries and arteries in the body. These are essential pathways that deliver oxygen and nutrients throughout the body, including the brain. Combined with high blood pressure and cholesterol, this can increase the risk of vascular dementia caused by damage to the blood vessels in the brain.

There is also a theory that diabetes can directly cause Alzheimer’s disease. Researchers explain that elevated blood sugar levels can increase a naturally occurring protein in the brain known as beta-amyloid. This protein is a sticky substance, and excess of it can create plaques or clumps in the brain that are characteristic of Alzheimer’s disease.

Preventing Dementia and Diabetes

Over a five-year span, older adults with type 2 diabetes may experience cognitive decline at double the rate of those without it. Luckily, there are many ways to reduce your risk of developing type 2 diabetes or be able to manage symptoms if you’ve already been diagnosed with it. 

• Eat plenty of dietary fiber, easily found in fruits, vegetables, and legumes
• Refrain from using tobacco products
• Limit alcohol consumption
• Limit added sugar and refined carbohydrates
• Get regular physical activity
• Manage weight if needed
• Eat healthy fats and proteins

Some people may need to use medications like insulin or metformin to help manage diabetes symptoms. The medication pioglitazone which helps your body better use insulin showed a 47% risk of dementia in patients with diabetes.

Dementia impacts not only those diagnosed with it but all of their loved ones and caretakers. Taking steps to prevent or manage diabetes can help you not only prevent dementia but feel better overall.